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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
D
E
C
A
L
P
R
R
B
V
R
A
M
E
R
U
D
E
C
O
R
P
D
O
E
R
A
C
I
D
E
M
R
I
A
F
T
S
H
S
B
E
O
O
A
G
E
U
D
A
I
F
V
G
V
G
N
T
N
P
R
F
Y
G
R
I
N
O
V
Q
C
G
T
J
D
K
D
O
S
E
S
O
E
A
N
G
M
E
S
F
B
X
B
S
T
B
Q
C
R
I
U
X
X
K
U
M
J
W
N
A
S
U
D
H
T
P
R
L
O
P
T
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